KATY H WINE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****05

License Status

ACTIVE

Business

First Name

KATY

Middle

Last Name

WINE

Business Name

KATY H WINE

Original Issue Date

09/17/2024

Effective Date

03/13/2026

Expiration Date

05/31/2028

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/13/2026